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Obesity Surgery
Published in: Obesity Surgery 8/2020

01-08-2020 | Endoscopy | Review

IFSO Position Statement on the Role of Esophago-Gastro-Duodenal Endoscopy Prior to and after Bariatric and Metabolic Surgery Procedures

Authors: Wendy A. Brown, Yazmin Johari Halim Shah, George Balalis, Ahmad Bashir, Almino Ramos, Lilian Kow, Miguel Herrera, Scott Shikora, Guilherme M. Campos, Jacques Himpens, Kelvin Higa

Published in: Obesity Surgery | Issue 8/2020

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Abstract

One of the roles of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) is to provide guidance on the management of patients seeking surgery for adiposity-based chronic diseases. The role of endoscopy around the time of endoscopy is an area of clinical controversy. In 2018, IFSO commissioned a task force to determine the role of endoscopy before and after surgery for the management of adiposity and adiposity-based chronic diseases. The following position statement is issued by the IFSO Endoscopy in Bariatric/Metabolic Surgery Taskforce. It has been approved by the IFSO Scientific Committee and Executive Board. This statement is based on current clinical knowledge, expert opinion, and published peer-reviewed scientific evidence. It will be reviewed regularly.
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Literature
1.
Fouse T, Brethauer S. Resolution of comorbidities and impact on longevity following bariatric and metabolic surgery. Surg Clin North Am. 2016;96:717–32.PubMed
2.
O’Brien PE, Hindle A, Brennan L, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg. 2019;29(1):3–14.
3.
Sjostrom L, Peltonen M, Jacobson P, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. Jama. 2014;311:2297–304.PubMed
4.
Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357:753–61.PubMed
5.
Sjostrom L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307:56–65.PubMed
6.
Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240:416–23.PubMedPubMedCentral
7.
Sjostrom L. Review of the key results from the Swedish obese subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.PubMed
8.
Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.PubMed
9.
Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide Survey 2016: Primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–3794.
10.
Shaheen NJ, Weinberg DS, Denberg TD, et al. Upper endoscopy for gastroesophageal reflux disease: best practice advice from the clinical guidelines Committee of the American College of Physicians. Ann Intern Med. 2012;157:808–16.PubMed
11.
Moayyedi P, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017;112:988–1013.PubMed
12.
Tolone S, Cristiano S, Savarino E, et al. Effects of omega-loop bypass on esophagogastric junction function. Surg Obes Relat Dis. 2016;12:62–9.PubMed
13.
Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-en-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg. 2016;26:926–32.PubMed
14.
Arman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12:1778–86.PubMed
15.
Barr AC, Frelich MJ, Bosler ME, et al. GERD and acid reduction medication use following gastric bypass and sleeve gastrectomy. Surg Endosc. 2017;31:410–5.PubMed
16.
Peterli R, Wolnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. Jama. 2018;319:255–65.PubMedPubMedCentral
17.
Chen RY, Burton PR, Ooi GJ, et al. The physiology and pathophysiology of gastroesophageal reflux in patients with laparoscopic adjustable gastric band. Obes Surg. 2017;27:2434–43.PubMed
18.
Wolter S, Dupree A, Miro J, et al. Upper gastrointestinal endoscopy prior to bariatric surgery-mandatory or expendable? An analysis of 801 cases. Obes Surg. 2017;27:1938–43.PubMed
19.
Parikh M, Liu J, Vieira D, et al. Preoperative endoscopy prior to bariatric surgery: a systematic review and meta-analysis of the literature. Obes Surg. 2016;26:2961–6.PubMed
20.
Sebastianelli L, Benois M, Vanbiervliet G, et al. Systematic endoscopy 5 years after sleeve gastrectomy results in a high rate of Barrett’s esophagus: results of a multicenter study. Obes Surg. 2019;29:1462–9.PubMed
21.
Salama A, Saafan T, El Ansari W, et al. Is routine preoperative esophagogastroduodenoscopy screening necessary prior to laparoscopic sleeve gastrectomy? Review of 1555 cases and comparison with current literature. Obes Surg. 2018;28:52–60.PubMed
22.
Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017;13:568–74.PubMed
23.
Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg. 2017;27:3092–101.PubMed
24.
Braghetto I, Gonzalez P, Lovera C, et al. Duodenogastric biliary reflux assessed by scintigraphic scan in patients with reflux symptoms after sleeve gastrectomy: preliminary results. Surg Obes Relat Dis. 2019;15(6):822–826.
25.
Lee WJ, Almalki OM, Ser KH, et al. Randomized controlled trial of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity: comparison of the YOMEGA and Taiwan studies. Obes Surg. 2019;29:3047–53.PubMed
26.
Hutopila I, Constantin A, Copaescu C. Gastroesophageal reflux before metabolic surgery. Chirurgia (Bucur). 2018;113:101–7.
27.
Saarinen T, Kettunen U, Pietilainen KH, et al. Is preoperative gastroscopy necessary before sleeve gastrectomy and Roux-en-Y gastric bypass? Surg Obes Relat Dis. 2018;14:757–62.PubMed
28.
Schneider R, Lazaridis I, Kraljevic M, et al. The impact of preoperative investigations on the management of bariatric patients; results of a cohort of more than 1200 cases. Surg Obes Relat Dis. 2018;14:693–9.PubMed
29.
Heimgartner B, Herzig M, Borbely Y, et al. Symptoms, endoscopic findings and reflux monitoring results in candidates for bariatric surgery. Dig Liver Dis. 2017;49:750–6.PubMed
30.
Fernandes SR, Meireles LC, Carrilho-Ribeiro L, et al. The role of routine upper gastrointestinal endoscopy before bariatric surgery. Obes Surg. 2016;26:2105–10.PubMed
31.
Mora F, Cassinello N, Mora M, et al. Esophageal abnormalities in morbidly obese adult patients. Surg Obes Relat Dis. 2016;12:622–8.PubMed
32.
Carabotti M, Avallone M, Cereatti F, et al. Usefulness of upper gastrointestinal symptoms as a driver to prescribe gastroscopy in obese patients candidate to bariatric surgery. A prospective study. Obes Surg. 2016;26:1075–80.PubMed
33.
Estevez-Fernandez S, Sanchez-Santos R, Marino-Padin E, et al. Esophagogastric pathology in morbid obese patient: preoperative diagnosis, influence in the selection of surgical technique. Rev Esp Enferm Dig. 2015;107:408–12.PubMed
34.
Wiltberger G, Bucher JN, Schmelzle M, et al. Preoperative endoscopy and its impact on perioperative management in bariatric surgery. Dig Surg. 2015;32:238–42.PubMed
35.
Petereit R, Jonaitis L, Kupcinskas L, et al. Gastrointestinal symptoms and eating behavior among morbidly obese patients undergoing Roux-en-Y gastric bypass. Medicina (Kaunas). 2014;50:118–23.
36.
Schigt A, Coblijn U, Lagarde S, et al. Is esophagogastroduodenoscopy before Roux-en-Y gastric bypass or sleeve gastrectomy mandatory? Surg Obes Relat Dis. 2014;10:411–7.PubMed
37.
Tolone S, Limongelli P, del Genio G, et al. Gastroesophageal reflux disease and obesity: do we need to perform reflux testing in all candidates to bariatric surgery? Int J Surg. 2014;12(Suppl 1):S173–7.PubMed
38.
D’Hondt MD, Steverlynck M, Elewaut A, et al. Value of preoperative esophagogastroduodenoscopy in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass. Acta Chir Belg. 2013;113:249–53.PubMed
39.
Peromaa-Haavisto P, Victorzon M. Is routine preoperative upper GI endoscopy needed prior to gastric bypass? Obes Surg. 2013;23:736–9.PubMed
40.
Pilone V, Di Micco R, Monda A, et al. Positive findings in preoperative testing prior to gastric banding- their real value. Minerva Chir. 2013;68:529–35.PubMed
41.
Humphreys LM, Meredith H, Morgan J, et al. Detection of asymptomatic adenocarcinoma at endoscopy prior to gastric banding justifies routine endoscopy. Obes Surg. 2012;22:594–6.PubMed
42.
Masci E, Viaggi P, Mangiavillano B, et al. No increase in prevalence of Barrett’s oesophagus in a surgical series of obese patients referred for laparoscopic gastric banding. Dig Liver Dis. 2011;43:613–5.PubMed
43.
Bueter M, Thalheimer A, le Roux CW, et al. Upper gastrointestinal investigations before gastric banding. Surg Endosc. 2010;24:1025–30.PubMed
44.
Kuper MA, Kratt T, Kramer KM, et al. Effort, safety, and findings of routine preoperative endoscopic evaluation of morbidly obese patients undergoing bariatric surgery. Surg Endosc. 2010;24:1996–2001.PubMed
45.
Merrouche M, Sabaté J-M, Jouet P, et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients before and after bariatric surgery..pdf. Obes Surg. 2007;17:894–900.PubMed
46.
Azagury D, Dumonceau JM, Morel P, et al. Preoperative work-up in asymptomatic patients undergoing Roux-en-Y gastric bypass: is endoscopy mandatory? Obes Surg. 2006;16:1304–11.PubMed
47.
Korenkov M, Sauerland S, Shah S, et al. Is routine preoperative upper endoscopy in gastric banding patients really necessary. Obes Surg. 2006;16:45–7.PubMed
48.
Gutschow CA, Collet P, Prenzel K, et al. Long-term results and gastroesophageal reflux in a series of laparoscopic adjustable gastric banding. J Gastrointest Surg. 2005;9:941–8.PubMed
49.
de Jong JR, van Ramshorst B, Timmer R, et al. The influence of laparoscopic adjustable gastric banding on gastroesophageal reflux. Obes Surg. 2004;14:399–406.PubMed
50.
Suter M, Dorta G, Giusti V, et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14:959–66.PubMed
51.
Frigg A, Peterli R, Zynamon A, et al. Radiologic and endoscopic evaluation for laparoscopic adjustable gastric banding: preoperative and follow-up. Obes Surg. 2001;11:594–9.PubMed
52.
Kavanagh R, Smith J, Bashir U, Jones D, Avgenakis E, Nau P. Optimizing bariatric surgery outcomes: a novel preoperative protocol in a bariatric population with gastroesophageal reflux disease. Surg Endosc. 2020;34(4):1812–1818.
53.
Sun WYL, Dang JT, Switzer NJ, et al. The utility of routine esophagogastroduodenoscopy before laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2017;13:1717–22.PubMed
54.
Gomez V, Bhalla R, Heckman MG, et al. Routine screening endoscopy before bariatric surgery: is it necessary? Bariatr Surg Pract Patient Care. 2014;9:143–9.PubMedPubMedCentral
55.
Dutta SK, Arora M, Kireet A, et al. Upper gastrointestinal symptoms and associated disorders in morbidly obese patients: a prospective study. Dig Dis Sci. 2009;54:1243–6.PubMed
56.
Loewen M, Giovanni J, Barba C. Screening endoscopy before bariatric surgery: a series of 448 patients. Surg Obes Relat Dis. 2008;4:709–12.PubMed
57.
Mong C, Van Dam J, Morton J, et al. Preoperative endoscopic screening for laparoscopic Roux-en-Y gastric bypass has a low yield for anatomic findings. Obes Surg. 2008;18:1067–73.PubMed
58.
Vanek VW, Catania M, Triveri K, et al. Retrospective review of the preoperative biliary and gastrointestinal evaluation for gastric bypass surgery. Surg Obes Relat Dis. 2006;2:17–22. discussioon −3PubMed
59.
Zeni TM, Frantzides CT, Mahr C, et al. Value of preoperative upper endoscopy in patients undergoing laparoscopic gastric bypass. Obes Surg. 2006;16:142–6.PubMed
60.
Madan AK, Speck KE, Hiler ML. Routine preoperative upper endoscopy for laparoscopic gastric bypass- is it necessary. Am Surg. 2004;70:684–6.PubMed
61.
Sharaf RN, Weinshel EH, Bini EJ, et al. Endoscopy plays an important preoperative role in bariatric surgery. Obes Surg. 2004;14:1367–72.PubMed
62.
Schirmer B, Erenoglu C, Miller A. Flexible endoscopy in the management of patients undergoing Roux-en-Y gastric bypass. Obes Surg. 2002;12:634–8.PubMed
63.
Mazzini GS, Madalosso CA, Campos GM, et al. Factors associated to abnormal distal esophageal exposure to acid and esophagitis in individuals seeking bariatric surgery. Surg Obes Relat Dis. 2019;15:710–6.PubMed
64.
Viscido G, Gorodner V, Signorini F, et al. Laparoscopic sleeve gastrectomy: endoscopic findings and gastroesophageal reflux symptoms at 18-month follow up. J Laparoendosc Adv Surg Tech A. 2018;28:71–7.PubMed
65.
Schlottmann F, Sadava E, Reino R, et al. Preoperative endoscopy in bariatric patients may change surgical strategy. Acta Gastroenterol Latinoam. 2017;47:117–21.
66.
Czeczko LE, Cruz MA, Klostermann FC, et al. Correlation between pre and postoperative upper digestive endoscopy in patients who underwent Roux-en-Y gastrojejunal bypass. Arq Bras Cir Dig. 2016;29:33–7.PubMedPubMedCentral
67.
Assef MS, Melo TT, Araki O, et al. Evaluation of upper gastrointestinal endoscopy in patients undergoing bariatric surgery. Arq Bras Cir Dig. 2015;28(Suppl 1):39–42.PubMedPubMedCentral
68.
Dietz J, Ulbrich-Kulcynski JM, Souto KEP, et al. Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients. Arq Gastroenterol. 2012;49:52–5.PubMed
69.
Munoz R, Ibanez L, Salinas J, et al. Importance of routine preoperative upper GI endoscopy: why all patients should be evaluated? Obes Surg. 2009;19:427–31.PubMed
70.
de Moura AA, Cotrim HP, Santos AS, et al. Preoperative upper gastrointestinal endoscopy in obese patients undergoing bariatric surgery: is it necessary? Surg Obes Relat Dis. 2008;4:144–9. discussion 50-1
71.
Teivelis MP, Faintuch J, Ishida R, et al. Endoscopic and ultrasonographic evaluation before and after Roux-en-Y gastric bypass for morbid obesity. Arq Gastroenterol. 2007;44:8–13.PubMed
72.
Abd Ellatif ME, Alfalah H, Asker WA, et al. Place of upper endoscopy before and after bariatric surgery: a multicenter experience with 3219 patients. World J Gastrointest Endosc. 2016;8:409–17.PubMedPubMedCentral
73.
Yardimci E, Bozkurt S, Baskoy L, et al. Rare entities of histopathological findings in 755 sleeve gastrectomy cases: a synopsis of preoperative endoscopy findings and histological evaluation of the specimen. Obes Surg. 2018;28:1289–95.PubMed
74.
Mihmanli M, Yazici P, Isil G, et al. Should we perform preoperative endoscopy routinely in obese patients undergoing bariatric surgery? Bariatr Surg Pract Patient Care. 2016;11:73–7.
75.
Baysal B, Kayar Y, Danalioglu A, et al. The importance of upper gastrointestinal endoscopy in morbidly obese patients. Turk J Gastroenterol. 2015;26:228–31.PubMed
76.
Abou Hussein B, Khammas A, Shokr M, et al. Role of routine upper endoscopy before bariatric surgery in the Middle East population: a review of 1278 patients. Endosc Int Open. 2018;6:E1171–e6.PubMedPubMedCentral
77.
D’Silva M, Bhasker AG, Kantharia NS, et al. High-percentage pathological findings in obese patients suggest that esophago-gastro-duodenoscopy should be made mandatory prior to bariatric surgery. Obes Surg. 2018;28:2753–9.PubMed
78.
Praveenraj P, Gomes RM, Kumar S, et al. Diagnostic yield and clinical implications of preoperative upper gastrointestinal endoscopy in morbidly obese patients undergoing bariatric surgery. J Laparoendosc Adv Surg Tech A. 2015;25:465–9.PubMed
79.
Sharma A, Aggarwal S, Ahuja V, et al. Evaluation of gastroesophageal reflux before and after sleeve gastrectomy using symptom scoring, scintigraphy, and endoscopy. Surg Obes Relat Dis. 2014;10:600–5.PubMed
80.
Al Akwaa AM, Alsalman A. Benefit of preoperative flexible endoscopy for patients undergoing weight-reduction surgery in Saudi Arabia. Saudi J Gastroenterol. 2008;14:12–4.PubMedPubMedCentral
81.
Ng JY, Cheng AKS, Kim G, et al. Is elective gastroscopy prior to bariatric surgery in an Asian cohort worthwhile? Obes Surg. 2016;26:2156–60.PubMed
82.
Lee J, Wong SK, Liu SY, et al. Is preoperative upper gastrointestinal endoscopy in obese patients undergoing bariatric surgery mandatory? An Asian perspective. Obes Surg. 2017;27:44–50.PubMed
83.
Wong HM, Yang W, Yang J, et al. The value of routine gastroscopy before laparoscopic Roux-en-Y gastric bypass surgery in Chinese patients. Surg Obes Relat Dis. 2015;11:303–7.PubMed
84.
Tai CM, Huang CK, Lee YC, et al. Increase in gastroesophageal reflux disease symptoms and erosive esophagitis 1 year after laparoscopic sleeve gastrectomy among obese adults. Surg Endosc. 2013;27:1260–6.PubMed
85.
Korenkov M, Sauerland S, Shah S, et al. Is routine preoperative upper endoscopy in gastric banding patients really necessary? Obes Surg. 2006;16:45–7.PubMed
86.
Schigt A, Coblijn U, Lagarde S, et al. Is esophagogastroduodenoscopy before Roux-en-Y gastric bypass or sleeve gastrectomy mandatory? Surg Obes Relat Dis. 2014;10:411–7. quiz 565-6PubMed
87.
Schirmer B, Erenoglu C, Miller A. Flexible endoscopy in the management of patients undergoing Roux-en-Y gastric bypass. Obes Surg. 2002;12:634–8.PubMed
88.
Wang Q-L, Xie S-H, Wahlin K, et al. Global time trends in the incidence of esophageal squamous cell carcinoma. Clin Epidemiol. 2018;10:717–28.PubMedPubMedCentral
89.
Kim Y, Park J, Nam B-H, et al. Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011. Epidemiol Health. 2015;37:e2015006–e.PubMedPubMedCentral
90.
Whiteman DC, Kendall BJ. Barrett’s oesophagus: epidemiology, diagnosis and clinical management. Med J Aust. 2016;205:317–24.PubMed
91.
Aggarwal S, Bhambri A, Singla V, Dash NR, Sharma A. Adenocarcinoma of oesophagus involving gastro-oesophageal junction following mini-gastric bypass/one anastomosis gastric bypass. J Minim Access Surg. 2019;16(2):175–178.
Metadata
Title
IFSO Position Statement on the Role of Esophago-Gastro-Duodenal Endoscopy Prior to and after Bariatric and Metabolic Surgery Procedures
Authors
Wendy A. Brown
Yazmin Johari Halim Shah
George Balalis
Ahmad Bashir
Almino Ramos
Lilian Kow
Miguel Herrera
Scott Shikora
Guilherme M. Campos
Jacques Himpens
Kelvin Higa
Publication date
01-08-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 8/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04720-z

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